It's not that all cultures are of the same quality. Some cultures are better than others. They have more value. Other cultures are pretty miserable, and some cultures are outright shitty, and should be eradicated. European culture, for example, is deplorable. The Arab and Chinese cultures are much better.

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San Antonio
Texas: Company Releases 'Child Love Dolls' to Stop Pedophiles Rumor: A company has released 'child love dolls' to provide a safe sexual outlet for pedophiles.

Snopes

Could you look into the validity of a supposed new company that will be marketing “love dolls” for pedophiles?

ORIGINS: On 13 April 2015, the entertainment web site Celebtricity published a hoax article reporting that a former sexual molestation victim had started a company to produce lifelike male and female “child love dolls” that pedophiles could have sexual relations with in place of molesting real children:

Buck Dobson knows what it is like to suffer at the hands of pedophile. He was repeatedly molested at age 10 by his 19-year-old-sister and says the scars have never healed. However, the abuse inspired Dobson to spend most of his adult life working to cure pedophilia. For years, Dobson tried to rehabilitate pedophiles within the Colorado prison system and through Christian outreach programs, but Dobson said his efforts failed.

“Look, you can’t change a pedophile’s sexual-orientation, and that’s what it is, an orientation, any more than you can a homo or heterosexual’s,# Dobson told Christian Family Daily. #You can try to get a pedophile to refrain from touching kids — and that sometimes works — but these people desire children and that desire is deep inside their genes. So why try to fix something unfixable?”

Instead, Dobson is starting a company that will create and market life-like male and female child and baby love dolls that pedophiles can molest and have sexual relations with.

“#These dolls will feel and smell just like real children and have all the naughty parts,”# Dobson said. “#Pedophiles are gonna love them.”

Unlike many “satire” sites operating on the Internet, Celebtricity occasionally posts real news stories in addition to its fake news pieces in an effort to confuse readers. That strategy seems to have worked, as many readers have shared this “news” about “love dolls” for pedophiles as if it were a factual account. Nonetheless, Celebtricity‘s disclaimer reveals the nature of that site:

Celebtricity.com is a combination of real shocking news and satirical entertainment to keep its visitors in a state of disbelief.

In January 2016, life appeared to imitate fake news, as stories emerged that a company is, indeed, producing dolls similar to the ones previously described. Shin Takagi owns Trottla, a company that produces anatomically-correct child sex dolls that he says are manufactured in order to help pedophiles control their urges. “I am helping people express their desires, legally and ethically,” Takagi told The Atlantic .

“We should accept that there is no way to change someone’s fetishes…. It’s not worth living if you have to live with repressed desire.”

However, the Celebtricity entry clearly falls into the category of “satire” rather than “real shocking news”: In addition to the fact that the article is missing key information (such as the name of the company putatively planning to release these “love dolls”), the image accompanying the article was swiped from the web site of French artist Lauren Curet, who creates detailed miniature child dolls from polymer clay as artworks rather than as sexual playmates for pedophiles.

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30 percent of all Chinese men suffer from a certain medical condition which actually is a birth defect, and which is called a micropenis (less than 1 inch). This is why the Chinese are so good in making money. They have to be good for something.

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San Diego
California: In Hypogonadism, Stroke May Be Prevented With Testosterone Replacement Therapy

Testosterone replacement therapy (TRT) may exhibit a protective effect against myocardial infarction, stroke, and all-cause mortality in men with secondary hypogonadism. The findings were presented at the 26th Annual Scientific and Clinical Congress of the American Association for Clinical Endocrinologists (AACE), held May 3-7, 2017, in Austin, Texas.

Given that there has been growing concern that TRT may be associated with an increased risk for adverse cardiovascular outcomes or mortality, investigators led by Joyce George, MD, of the Cleveland Clinic in Ohio, conducted a retrospective cohort study using electronic health records from a large health care database to examine outcomes.

Records for men at least 40 years of age, with at least 2 testosterone levels <220 ng/dL (one obtained between 7 am and 10 am) were pulled from the database. Patients with primary hypogonadism, secondary hypogonadism related to overt hypothalamic pituitary pathology, HIV infection, metastatic cancer, a history of prostate cancer, prostate specific antigen >4 ng/mL, elevated hematocrit, or a history of previous thromboembolic disease were not included in the final cohort.

The study ultimately included 418 men (median age 53.8 years) exposed to TRT and 283 matched controls (median age 54.9 years; P =.02). At baseline, the prevalence of established cardiovascular disease was 9.8% vs 12.7%, respectively (P =.23). The treatment group was followed for a median of 3.8 years compared with 3.4 years for the control group.

The event composite outcome in the treatment group was 3.3% compared with 6.4% in the control group, with the investigators ultimately observing a reduction in the odds of the combined cardiovascular end point in the treatment group (hazard ratio [HR] 0.49; 95% CI, 0.24-0.99; P =.046).

While “the effect of TRT may vary considerably depending on the etiology of low testosterone, the patient's age, and whether or not they have established CV [cardiovascular] disease,” the results suggest TRT may protect some men with hypogonadism from cardiovascular events, the investigators concluded.

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Dallas
Texas: Anesthesia Awareness—What If I Am Awake During Surgery?

Updated on November 4, 2016

TahoeDoc HealDove

Anesthesia Awareness - Awake Under Anesthesia

Fear of being awake under anesthesia, called anesthesia awareness or intraoperative awareness, causes a lot of anxiety for patients facing surgery.

Having anesthesia is scary for most people. As an anesthesiologist, I usually meet patients right before their surgeries. People facing surgery have many apprehensions and fears. More and more are concerned about anesthesia awareness.

I repeatedly hear that patients are often more apprehensive about the anesthesia than the surgery itself. And of all the fears that people have about the anesthetic side effects and anesthetic complications, the one I hear most often is, "I'm afraid of waking up during the surgery."

Anesthesia awareness has received a great deal of attention in the press over the last few years and even a full-length movie, called "Awake," capitalized on this fearful concept (I have reluctantly included the trailer here). But what is it really? Why and to whom does it occur? Keep reading to find out why it most likely won't happen to you.

"Awake" - Sensationalizing Anesthesia Awareness

What Is Anesthesia Awareness?

Anesthesia awareness, also called intraoperative awareness refers to a specific situation where a person is under general anesthesia for surgery and regains consciousness during the surgical procedure.

The definition of general anesthesia includes induction and maintenance of loss of consciousness. This means that you should not be able to wake up until the surgery is over. You do not respond to voice or painful stimuli.

For various reasons, some people do regain consciousness when they are under general anesthesia. For most people, this involves a very brief, hazy memory. Some people are aware of what is being said, but cannot move or indicate that they are awake. Still, there is usually no sensation of pain or awareness of the operation. The very rare, unfortunate few are awake, cannot move and do feel the surgery being done.

Sedation anesthesia. I often have patients tell me they had anesthesia awareness during their colonoscopy or other procedure. These procedures are commonly done under intravenous sedation anesthesia. While the intravenous sedation drugs do cause sleepiness and often amnesia- you don't remember the procedure, they do not cause unconsciousness. It is not at all abnormal to be awake and remember these procedures. With the sedation, pain medications are either injected at the surgical site or given in the IV or both. You should still not be uncomfortable, even if you are awake, during surgeries or procedures under sedation.

Sedation plus spinal or epidural. Neither sedation or spinal/epidural anesthesia makes you unconscious during your operation. If you have spinal or epidural anesthesia to block the pain of surgery, you are usually also given sedation. The same is true for local anesthesia as well. In this case, it is not unusual or abnormal to have memories of being in the operating room. This is not anesthetic awareness.

Dreaming. Some people actually dream during their anesthetic, or more likely, when transitioning from unconsciousness back to wakefulness at the end of surgery. These dreams are often interpreted as actual wakefulness, but are not.

Waking at the end of surgery, but not able to move. When you return to consciousness, sometimes your brain is more awake than your body. You are waking up, but cannot move for a couple minutes. You can hear the anesthesiologist talking to you or feel the nurses putting bandages on your incisions, but cannot yet respond. The anesthesia wears off at different rates for different people. If your surgery is over, but you are still in the operating room and have memories of this, it is a normal variant of the emergence phase from anesthesia. Most people are conscious when they leave the operating room, post anesthesia, and many are talking and asking questions, but may not remember it later. If you do remember this phase, it's ok. The same is true for the beginning of your anesthetic, the anesthesia induction. Vague, hazy memories of being in the operating room are confusing and can be mistaken for being awake during the anesthetic.

Risk Factors for Intraoperative Awareness

Certain risk factors make anesthesia awareness more likely.

Type of surgery and type of anesthesia. Certain types of surgery are associated with higher incidences of anesthesia awareness. Surgeries where using lower concentrations and amounts of anesthetics is necessary to protect patients lead to more intraoperative awareness. Emergency cesarean sections, trauma surgeries, and open heart surgeries are the most likely cases to be associated with anesthesia awareness. Anesthesia challenges the body's physiology. Heart rates vary and blood pressures drop. When they cannot be adequately managed by giving more medication, the anesthetic must be "lightened" in order to NOT endanger the patients' lives.

There are certain brain and spinal cord surgeries that require that no anesthesia gas be used in order to not interfere with the nerve monitoring being used to prevent paralysis. The anesthetic called TIVA (total intra-venous anesthesia) also predisposes to higher rates of anesthesia awareness.

Type of patient. Patients who use illegal drugs such as cocaine and methamphetamine may be more likely to have intraoperative awareness. Not only do these drugs cause dangerous fluctuations in heart rate and blood pressure, they make the metabolism of anesthetic drugs much more unpredictable.

Some prescription medications. Certain prescription medications may also increase the risk. Anesthetics are adjusted throughout the surgery based on surgical stimulation level, type of anesthesia and the heart rate, breathing rate and blood pressure of the patient. Patients who take medications that block the normal increases in heart rate or blood pressure may have their signs of light anesthesia masked by the medication.

Statistics on Awareness Under Anesthesia

The American Society of Anesthesiologists estimates that some degree of anesthesia awareness occurs in about 1 in 1000 general anesthetics. It is believed that the majority of these cases are during the induction (beginning) of the anesthetic when the drugs haven't fully taken effect. Likewise, a great many cases are at the end of surgery, during anesthetic emergence, when the anesthetic is wearing off but isn't completely gone. These are not intraoperative awareness as the surgery is not occurring. Because the memories are fuzzy and confusing, patients often don't know that this wasn't during the surgery itself.

There are no exact statistics on true intraoperative awareness cases that occur during the surgery and cause distress and lasting trauma to the patient. It is, however, an area of active study and research.

Again, talk to your doctors and ask questions if you are remotely concerned that this has happened to you.

Prevention: What You Can Do to Prevent Intraoperative Awareness.

Talk to your anesthesia doctor and provide accurate information. This is your best defense against intraoperative awareness.

So, be honest with your doctor about:

Your fears. Usually, this will help calm you. While no absolute guarantees can ever be made, your doctor can help pinpoint whether or not you have higher risk than average for this complication and let you know how he or she will address the risk. Alcohol consumption. Chronic, excessive alcohol intake results in a higher need for anesthetic medications. Illegal drugs use. Your anesthesiologist needs to know this to figure out which and how much anesthesia it will take to get you to sleep and keep you there. They are not there to judge you, but cannot keep you safe if they don't have all relevant information. All of your prescriptions and supplements. Different medications affect the metabolism of anesthesia differently. And just because supplements are "natural" or "alternative" doesn't mean they don't have side-effects or don't interfere with anesthetic medicines. How the Anesthesiologist Monitors During Surgery

The anesthesiologist, using intraoperative monitoring, will be watching your heart rate, blood pressure, and breathing rate (if a ventilator doesn't need to be used). Increases in these seen on the intraop monitors indicates that the anesthesia is too "light." These parameters generally increase before any awareness occurs. The anesthesiologist is constantly adjusting the delivery of the anesthesia gas and giving other medication in the IV to keep the anesthesia level where it needs to be. The anesthesia is increased to ensure adequate depth of anesthesia if it's too light. Likewise, even though you are unconscious, your body will reflexively move to stimulation if the anesthetic depth needs to be increased. This also occurs before awareness.

The various brain monitors on the market have not been shown to reduce anesthesia awareness, despite what the makers of these expensive devices say. They do provide other useful information and may or may not be used if your hospital has them, at the discretion of the anesthesiologist.

BIS Monitor

A study published in the "New England Journal of Medicine" (August 18, 2011) has actually shown that relying on a BIS (brain) monitor can actually increase the incidence of intraoperative awareness vs. using measurement of the anesthetic concentration (the usual technique). This sounds counter-intuitive, but to me is not surprising. Here's why...

The BIS monitor (which I use for other information) gives a number that is indicates the level of consciousness. Other indicators include heart rate, blood pressure and breathing rate/pattern changes (if the patient is breathing on their own). In my experience (disclaimer-based on only my experience, not scientific study), the changes in vital signs happen first. Heart rate goes up before you see a change in the BIS number. That means that providers who rely only on the BIS number and ignore the changes in vital signs may be missing the chance to prevent awareness. The awareness may have already happened before the change in BIS number is seen. There is a lag between the event and the change in BIS.

Personally, I try to use all the data available to me and not rely on the BIS monitor for prevention of awareness. Vital signs to me are more reliable, happen earlier (before awareness can occur in most cases) and should not be ignored to focus on the BIS monitor. The BIS does provide other useful info, but is not as reliable as the manufacturer may claim to prevent awareness.

Treatment for Anesthesia Awareness

If you have had a case of genuine intraoperative awareness, let your doctor, surgeon, or anesthesiologist know right away. Many people do well with just an explanation of why it might have happened. Others suffer short-term or even long-term post-traumatic stress disorder. In those cases, an evaluation by a psychologist or psychiatrist and possible medications may be needed, usually on a short-term basis.

If you aren't sure if you had true anesthesia awareness, speak to your surgeon or contact the anesthesiologist. Most people who aren't sure have had one of the other experiences -- like sedation, dreaming, or waking at the end and being confused about the time -- and feel much better after having their questions answered.

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She has dark brown hair, greenish eyes and appears to wear a lot of make-up.

Oh, and for most of the past month, she has been at the centre of one of the most sordid and downright surreal court cases in living memory.

Yet as the high-stakes civil proceedings have progressed, the ‘Vamp in the Veil’ case has grown increasingly strange and sleazy.

On Wednesday, for example, Ms Al Amoudi attempted to prove that she is incredibly wealthy — and presumably therefore does not need to defraud anyone — by insisting, under oath, that she spent almost £1 million on perfume in just a few weeks.

‘I have a problem with shopping,’ she declared. ‘In the past two months, my perfume, only the perfume … $1.4 million (£912,000). I can show you the pictures.’

Earlier, key players in the case were accused of conducting illicit sexual affairs, concealing addictions to drink and drugs, and prostituting themselves, more of which later.

Then there is a dark back-story involving a dead former business associate — and alleged ex-lover — of Al Amoudi, who is accused of dabbling in the occult with her at the Cliveden estate in Berkshire, scene of the Profumo scandal, again more of which later.

At the centre of these dizzying claims and counter claims there sits a huge unanswered question: Who exactly is this woman?

For, as proceedings have progressed, it has become apparent that no one — least of all Judge Sarah Asplin, who must decide the eventual outcome of the extraordinary trial — is entirely sure.

For example, several acquaintances have told the court that for years Al Amoudi has described herself as a Saudi royal.

One, an elderly hereditary peer called Lord Mereworth, who met her several years ago, said she had talked to him of being the estranged wife of King Abdullah, the country’s monarch.

‘I understood she was married to the king of Saudi,’ he said.

Yet in her own evidence to court this week, Al Amoudi — who has produced no credible birth, marriage or other document confirming her identity — denied having made such a claim.

A former boyfriend once told reporters that she spoke of being Osama Bin Laden’s daughter, claimed to be a friend of Kate Moss, and talked of dating two Hollywood film stars — Irish former hellraiser Colin Farrell and Gladiator star Joaquin Phoenix — as well as former Arsenal footballer Freddie Ljunberg.

However, there is no evidence of her having any link to the Bin Laden family, and none of the supposed celebrity acquaintances will admit to having anything to do with her.

A few years ago, in a successful application for a £4 million mortgage from a bank, that was shared with the court, Ms Al Amoudi allowed the bank to assume wrongly that she was the daughter of Sheikh Mohammed Hussein Al Amoudi, one of the world’s wealthiest men.

Yet the Ethopian-Saudi billionaire’s legal representatives, who were in court all week, have issued a formal denial of paternity.

At various other points, she has told acquaintances that her father is Mohammed bin Aboud Al-Amoudi, the super-wealthy owner of the Intercontinental Hotel in Jeddah.

But the businessman’s representatives have vigorously disputed that claim, too.

Then there is the question of the source of Ms Al Amoudi’s apparent wealth. In legal papers, she has claimed to be a Saudi-born heiress, married at 13 and exiled from the country in the Nineties because of an adulterous relationship.

After arriving in London almost two decades ago, she says she has existed thanks to a £100,000 weekly allowance, sent by her family in the form of suitcases filled with banknotes.

Yet one of the two plaintiffs in the fraud case, 56-year-old property developer Amanda Clutterbuck, a well-preserved blonde, alleged this week that Al Amoudi earns her crust as a high-class prostitute, who for years worked from a £750,000 flat, with two sisters, yards from Harrods.

‘Far from being Saudi Arabian princesses, they were all prostitutes,’ she said, claiming that the women would trawl Harrods in search of clients.

Asked about that allegation in court, Al Amoudi claimed ‘in the name of Allah’ to be ‘a good Muslim woman’.

Certainly, there are questions about how rich Ms Al Amoudi actually is. In court on Tuesday, she claimed that her wealth was genuine, citing her expenditure on perfume as evidence.

‘I’m afraid I’m addicted to spending money and get through enormous amounts of cash,’ she said. ‘I can easily spend £50,000 to £100,000 in one spree.’

Yet the very next day, despite her luxury cars and huge entourage of employees, she suddenly declared herself ‘broke’, telling the judge: ‘I don’t have anything!’

It was a typically odd moment in a surreal three days during which Al Amoudi gave evidence to the court.

She had agreed to remove her veil in court, but sat behind a wall of document files, so that her face was invisible to most of the onlookers.

During hours of rambling testimony, at times she talked so softly that she could barely be heard; at other times she raised her voice and broke into hysterics or tears.

Often (but not always) she adopted a heavy Middle Eastern accent.

On several occasions, Al Amoudi insisted she could barely understand proceedings and needed to speak through an interpreter — only to break into eloquent English moments later.

At one such point, the court dissolved into laughter when the opposition counsel thanked her for suddenly being ‘fluent in English again’.

Things were similarly odd during Ms Al Amoudi’s last brush with the law, a 2010 trial at Southwark Crown Court when a former boyfriend, Swedish male model Patrick Ribbsaeter, stood accused of assaulting her driver.

Back then, she appeared in a bejewelled burka to give evidence for the prosecution, who claimed Ribbsaeter was a ‘gold digger’ after her money. Following his acquittal, he claimed Al Amoudi’s devout appearance during the trial was a facade.

During their short, volatile relationship, he claimed, ‘she didn’t wear the burka as a rule — she wore designer clothes,’ many of them revealing.

Al Amoudi also frequented upscale London bars, restaurants and nightclubs. ‘She was drinking champagne every night,’ he said.

‘She had a lot of issues … who knows what the truth is about this strange woman?’

One person who claims to know the truth is South London furniture dealer Negat Ali, who came forward after seeing Al Amoudi’s unveiled picture in the Daily Mail and told the court she knew her of old.

The ‘Vamp in the Veil’ is not a royal or even a Saudi, Ali claimed: she is an Ethiopian who later lived in Yemen and Dubai, she insisted.

Ms Ali, who is originally Ethiopian but now works in Battersea, claims to have met Al Amoudi in 1985.

She then ran into her again by chance in 1996 at the London strip club Stringfellow’s, where they were attending a ‘ladies’ night’.

The two women went on to share a flat in Bayswater, she said.

In 2000, Al Amoudi fell pregnant and gave birth to a daughter at St Mary’s Hospital in Paddington, where the Duke and Duchess of Cambridge’s son, Prince George, was born this week.

That daughter, who is now aged 13, is at boarding school.

Ms Ali claims that she lived with Al Amoudi for several years — during which time the infant was used to seek maintenance payments from a variety of men — before they fell out over an alleged unpaid debt of £500.

Ms Ali suspects the ‘Vamp in the Veil’ is not actually a Muslim and uses her burka as a disguise during public appearances to prevent old acquaintances, and clients, from recognising her.

Al Amoudi’s barrister, for his part, accused Negat Ali of being a disgruntled former servant trying to settle an old score with claims that are entirely untrue.

The nuts and bolts of the court case revolve around a disputed property deal.

The plaintiffs, Ms Clutterbuck and her partner Ian Paton, allege that Ms Al Amoudi cultivated their friendship over several years.

She then carried out a ‘very accomplished’ face-to-face fraud, convincing them to sign over six properties to her as security for a major future cash advance.

They say she claimed to be hugely wealthy and willing to act as a partner helping to secure finance on a deal to buy properties worth £170 million on Hans Place in Knightsbridge.

Al Amoudi allegedly told them she could secure a loan of £46 million from contacts in the Middle East. In exchange, they signed over to her the titles to six London properties.

But the massive loan never materialised, and now the couple want the properties, which are worth £14 million, to be returned.

‘I thought I was living through an Alfred Hitchcock film, in which reality seemed to be totally distorted,’ said Ms Clutterbuck — who counts the Duke of Gloucester among her social circle — recalling the moment she came to believe she had been conned.

Al Amoudi, for her part, claims that Paton signed over the flats to her in order to repay debts he owed her from years as a crack cocaine addict.

She claimed Mr Paton had been her ‘lover’ for around a decade, taking millions of pounds from her over this time.

Mr Paton has denied ever sleeping with Ms Al Amoudi and says he has never taken crack cocaine.

As is common in civil proceedings, the case, which continues, will be decided by Judge Asplin, not a jury.

Crucial to the eventual verdict will be Sara Al Amoudi’s love life. In court, Ms Clutterbuck and Mr Paton’s barrister identified a string of men to whom she is believed to have been attached during the years she claims to have been conducting an affair with Mr Paton.

They include a man known only as ‘Sammy’, who is the father of her child, and one Gerald Jerko Zovko, who is believed to have been married to Al Amoudi until he was killed in Iraq in early 2004 while working as a private security contractor.

His vehicle was hit by rocket- propelled grenades in the town of Fallujah, and his mutilated body was then dragged through the streets by a mob.

Then there is Cliff Besley, an Australian triathlon champion who, the court was told, was introduced as her fiancé at business meetings in 2008, and an alleged boyfriend called Ryan Bish.

Another man, still in her life, is Lord Mereworth, an 83-year-old divorced, heirless and apparently very wealthy hereditary peer, who lives in Pimlico, South-West London.

He appears to have become entranced with Al Amoudi after meeting her a few years ago. They have dined together at the House of Lords, and he agreed to give evidence in her support.

During cross-examination, in which Lord Mereworth denied that she had ever proposed marriage to him, he claimed to be convinced of her legitimacy.

‘I may have been misled, who knows? But I still trust her,’ he said.

The final player in this extraordinary soap opera is an acquaintance of Amanda Clutterbuck, a man named Elliot Nichol, with whom Ms Al Amoudi appears to have had a lengthy affair.

Mr Nichol, who died of alcohol poisoning in December 2009, is said to have been obsessed with the occult. He would speak with Ms Al Amoudi on a mobile phone that had a number ending in 666 — which is popularly associated with the devil.

In the run-up to his death, Nichol was living with Al Amoudi at properties in central London and on the Cliveden estate in Berkshire, Ms Clutterbuck told the court.

‘At Christmas 2006, Mr Nichol phoned in an almost totally incoherent state, singing at the top of his voice: “I am drowning in Vuitton handbags and Cavalli, we’re thinking of floating them down the Thames.” ’

The ‘Vamp in the Veil’ denies being with Nichol at the time of that call.

As with almost everything about this mysterious woman, the truth is hard to ascertain. Now a judge will have the unenviable task of sorting fact from fiction in this most modern tale of greed and guile.